Archive for the ‘Insurance’ Category

Insurance “Coupons” Put Patients in the Chair

Wednesday, July 15th, 2015

Coupon use is growing. According to an analysis by The Neilsen Company, “more affluent households dominate coupon usage: 38% of ‘super heavy’ users and 41% of ‘enthusiasts’ come from households with incomes greater than $70,000. Households with incomes of $100,000 and up were the primary drivers of coupon growth…”

So, what does this have to do with dentistry? It is a reminder that attitudes toward money – specifically spending and saving – have changed significantly in recent years. Moreover, those most tuned into the value of the dollar – the better educated, higher income households – are also those most likely to understand the importance and value of your dental care.

However, as consumer savvy as this population may be, the majority of them don’t realize that they are likely losing $500, $250, $700 in your office. How? Many, many patients have dental insurance plans with unused benefits that are poised to go to waste come year’s end.

Dental insurance companies make millions of dollars off of patients who never use their insurance benefits because unbeknownst to the consumer, many of these plans provide coverage up to a certain dollar amount annually. Insurance companies aren’t going to encourage customers to use benefits, and it is rare that patients actually know what they have left in benefits. Most are too busy to sift through their policies to determine what might remain on them, which makes informing them about the benefit an excellent win-win opportunity for patients and dental practices.

Take these steps:

1.  Generate an “unscheduled treatment plan report.”
2.  Identify those patients who still have unused insurance benefits.
3.  Prepare and send a special letter to each patient.  ( I have templates for this if you or your office needs assistance)
4. Add a P.S. that says, “Take your insurance dollars further with interest-free patient financing. Ask ‘Jessica’ in my office for all the details.”

I can virtually guarantee that every patient you notify will thank you for calling this to their attention. Whether they take advantage of the opportunity or not, they will appreciate the fact that you took the time to educate them on this important insurance detail.



No Need to Fear Insurance

Monday, July 1st, 2013

Many dentists starting out in their careers fear that their practice will be dependent on insurance. Insurance is largely demographic driven. However, in this these economic times, taking insurance, at least a few of the better plans, is an excellent way to quickly build a solid patient base. The practice can still be primarily fee-for-service, but it is important that the new dentist make an informed decision based on demographic information about the community.


Making insurance work for the new practice requires that it be treated as you would any other practice payment system. Co-pays and deductibles should be collected from the patient at the time of service. Additionally, once a year the fee schedules must be updated for each preferred provider organization that the office is affiliated with. If the fee schedules are not updated in the practice’s computer system, over time the practice is billing the insurance provider for less than what it could be. For example, XYZ PPO had an exam reimbursement rate of $55 in 2012, but in 2013 that rate was increased to $60. Yet a practice will continue billing the insurance for only $55 because the business team hasn’t updated the fee schedule, the years go by, the fee schedules change, and the practice loses money it can never recoup.

In or Out of Network

Thursday, January 3rd, 2013

When it comes to insurance, oftentimes you will hear the terms “in-network” or “out-of-network.” Dentists who are “in-network” have agreed to a personal contract with a benefit plan. These contracts have restrictions and requirements and usually dictate adherence to a reduced fee schedule. Therefore, patients who chose an “in-network” dentist typically will pay less of their own money toward treatment than those who choose an “out-of-network” dentist. In addition, an “in-network” dentist usually is paid directly from the insurer and payment is sent to the office.


An “out-of-network” dentist has not signed a contract with the insurer of a particular plan. However, patients may still choose that dentist and have some of their fees covered, but they may pay more out of pocket. Also, plan payment checks are usually sent to the patient, not the dentist. The plan pays the patient, and then the patient pays the dentist. Or the patient pays the dentist and is later reimbursed by the plan.


A dentist who decides to become “in-network” may choose to do so because a large population of patients are on the plan, because s/he likes the security of receiving payment checks directly, or because the fee schedule seems fair. A dentist may decide to stay “out-of-network” because a smaller population of patients uses a particular plan. The dentists may be content with patients receiving payment checks. Or s/he may not be comfortable with the fee schedule. Be sure you have a very clear understanding of what specifically is dictated in the contract before becoming an “in-network” dentist.