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  04.07.05 Issue #162

How To Get Your Patient To Say “Yes”…To Your Total Fee

Tom Limoli

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Dental plans sure aren't what they used to be. Well, maybe they are? Let's all beat that dead horse one more time and maybe it will come back to life.

“I remember when dental insurance first came on the scene. The patient had a $1000 annual maximum and that got two crowns and two cleanings each year. Now it's 2005 and the annual maximum is still $1000. Don't the insurance companies know that barely covers a crown? When is the insurance industry going to change the annual maximum?”

Get over it. It's the patient's plan. The patient's employer selected the plan. And the base plan has a $1000 annual maximum. If they want more coverage they can purchase it. The more one pays for the plan the richer the benefits. In other words, you get what you pay for. Nothing more. Nothing less.

So how do you get the patient to say YES to treatment and most importantly YES to your total fee? It's easier then you think if you will just take a break from beating on the poor deceased horse.

The patient must understand that their dental plan is a financial benefit to help them offset the cost of care. The plan is not intended to pay your fee.

If we want the patient to accept responsibility for their plan we must first stop telling them about their plan. When you tell the patient about their individual benefit plan you come off as being the responsible authority. It's not your plan. It's not your responsibility.

Too many offices unknowingly waste valuable time on the phone, so called, researching benefit plan specifics. This is not helping the patient and most importantly not helping your bank deposit and bottom line. The patient's benefit plan need not become your administrative and financial responsibility.

As an example lets say the patient needs a root canal and crown on tooth number 6. Your fee for the root canal is $650 and the crown is $900. The patient must acknowledge and agree to be responsible to your office for the total fee prior to insurance consideration. Then and only then will the patient's benefit plan be there to help them offset the cost of dental care.

Ask the patient point blank, ”how will you be handling your commitment to our practice for $1550?” At this most critical moment of truth don't simply look at the patient for you must look through them. Look and see deeply into the dark recesses of their soul for they must say the magical phrase “I Have Insurance.” The patient must initiate the subject of insurance benefit.

Once the patient makes the acknowledgement follow up with something along the lines of “That's wonderful that you have a plan of benefit. Many patients in our practice do not have insurance. We will do all that we can to help YOU make this treatment as cost effective as possible by working with YOUR benefit plan to help YOU offset the total cost of dental care.”

The patient must make the correlation that the benefit plan is helping them offset the cost of care. The benefit plan is not paying part of your fee. We have the ability to make this happen when we make the patient bring up the subject of their dental benefits.

Start building your toolbox now. Get a fresh grip on presenting financial arrangements with the patient and stop being so anxious to tell them about their benefit plan.

Tom Limoli, Jr. is the author of “ Dental Insurance & Reimbursement Coding and Claim Submission Manual " to order click here. Tom can be reached at 404-252-7808.

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