Helping your patients understand their dental insurance is no easy task. After all, dental benefits are complex, vary by plan type and by insurance company, and can change yearly.

Two out of every three American adults carry dental insurance. As a result, having confidence when discussing the topic can keep patients happy and healthy, as well as your schedule full.

Talking to patients about dental insurance isn’t easy. Even if you have a background in billing or claims and have answers to any question a patient may ask (go you!), dental benefits is still a difficult topic.

But a full schedule and healthy A/R hinge on being at least conversant in dental insurance.

Time and time again, patients turn down treatment because of a lack of coverage. Or they get treatment and then complain about their patient portion of the bill.

How can we help them better understand dental insurance so they get the care they need and avoid the dreaded out-of-pocket surprise? Heck – how can we help team members better understand insurance?!

Dental insurance itself may never be easy. But these tips will make talking about it a little less stressful.

Get Your Team Members on the Same Page

Heidi Benson, a consultant at Advanced Practice Management, says that your team needs one thing when chatting with patients about dental benefits.

“Consistency,” says Benson, who has managed practices for 20 years. “It’s the biggest factor in how your office communicates with patients about insurance.”

To get your team on the same page, try these three easy tactics.

Make “Estimate” Part of Your Team’s Vocab

Perhaps the most important word to use with patients on the topic of insurance is “estimate.”

Your insurance-dedicated team member is the best point person for any discussions of coverage. That said, all staff are bound to be asked a question or two from patients about the cost of treatment.

To prepare for those cases, add insurance communication to your cross-training plans, and make sure that no one on the team offers a specific cost of a service or guarantees coverage.

Instead, encourage your team to emphasize that any potential cost is an estimate only.

Create Talking Points — and Share Them

Talking points are short, simple messages that a team uses to speak consistently about a topic. And according to Benson, talking points about dental insurance are a must-have for offices.

“These are great because they get everyone on message on how your office wants to speak about dental insurance.”

But remember: a change in message is a change in routine.

Creating talking points alone won’t ensure your team will use them. You’ll need to share them with the team and schedule some time to practice using them.

The time you set aside for team training is perfect for those sessions. But Ben Tuinei, an insurance analyst at Veritas Dental Resources, recommends that offices slowly build understanding, rather than giving the team tons of information all at once.

“Start small with morning huddles,” he says. “Then build it up to lunch and learns with an expert who can provide even more guidance on how to discuss insurance with your patients.”

Refer Complex Questions to Your Team’s Benefits Whisperer

What happens if a patient has a more-technical question? In those rare instances, refer the patient to the right team member.

Each team member has a job to do and is specially trained for that job. Make sure the right person is answering your patients’ questions.

What patients don’t realize is that your office is billing their insurance as a courtesy. Your office works for the patient, not the insurance company.

So, just be sure that what you present to the patient is an estimate based on what you know to be true about their particular insurance plan.

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Be Patient Focused, not Insurance Driven

We know all too often patients refuse treatment when they learn insurance won’t cover it. Some may mistakenly think that if insurance doesn’t cover it, then the treatment must not be necessary.

Yikes!

Fortunately, there are ways to prevent patients from bowing out of care when they have concerns about coverage.

Differentiate Dental Insurance from Medical Insurance

Consistently remind patients that dental insurance is not like medical insurance.

Dental insurance is more like a discount card, a way to help offset costs; it isn’t something that will cover everything after a deductible is met.

Help patients understand that their health is your priority. You want what’s best for them, and your recommendations are based on that – not on what their insurance will pay.

Avoid the trap of TMI

When discussing insurance with patients, keep it general, says Benson.

“One misstep that offices make is focusing too much on insurance details, like preauthorization and in-network and out-of-network costs,” she explains.

Benson warns that too much technical information can confuse patients. It could even lead them to think that your office isn’t right for them or too expensive.

For example, when a patient asks whether you take their insurance, answer them honestly. But if you don’t accept a plan, inform the patient that a visit at your office may be about the same cost as a visit with a plan your office does accept.

“You can say that you have many patients with that insurance and most see little or no difference with their plan,’” says Benson. 

An additional idea is to offer them a free first visit, since once they walk through the doors the first time, they’ll fall in love with your team and never look for another practice again!

Lean on Your Doctors and Practice Owner, Too

To build a patient-first mindset rather than an insurance-first one, you can also seek guidance from your practice’s doctors, says Ben Tuinei.

“The doctor can help all team members eliminate the insurance-driven mindset while helping patients manage their care needs,” Tuinei says. “The leader of the practice can instill that patient- and care-focused mindset among your team members.”

Move Sensitive Conversations to Another Room

Most people have some fear when it comes to hearing the price of a procedure or treatment.

And having to think through the cost while at the front desk in front of other waiting patients – it adds a layer of fear that others may find out about the patient’s financial situation.

The best place to talk to a patient about their insurance is a private room. (Bonus points if it’s cozy and has a computer or tablet to help patients visualize treatment.)

Here, you can talk through the patient’s need for treatment while helping them understand what their insurance covers. Reinforce the basics of how dental insurance works.

In a private setting, patients feel valued. Your attention is on them and not on a phone ringing or greeting other patients coming in.

When patients feel comfortable and valued, they will be better emotionally equipped to make informed decisions.

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Offer Multiple Touchpoints to Educate Patients

So you’ve helped patients understand their insurance – great! That’s one touchpoint.

But how often do we forget what we hear (or even sign off on)?

To help your patients learn more about insurance, here are a few other ideas:

  • Create wall signage. What’s your office’s biggest insurance-related headache? Hire someone to create some educational content for your walls on that topic. While patients wait, they can read it and soak it in.
  • Turn your website into an educational hub. Do you have a page or two dedicated to insurance information? Perhaps you share what insurances you are in network with. Go one step further with some FAQs that explain what you wish patients knew more about. You can also link out to sites that help define terms.
  • Post information on your waiting-room TV. Do you have TVs running content in your waiting room or operatories? Consider showing a slide with a couple key points on insurance.
  • Tie messages into treatment plan messages. Follow up on pending treatment with an email or text campaign, and include verbiage that connects that treatment with their health and wellbeing (versus only their insurance coverage).

Refer Patients to Their Dental Insurance Company

It’s important for patients to know you offer the most accurate information, to the best of your ability. Still, sometimes the right source of information is their insurance company.

Should a patient want to call the company to learn more about their benefits, give your patients as much information as possible.

The following items will make their call with the insurance company easier:

  • Exact treatment name
  • Treatment code
  • Patient’s insurance identification number
  • Patient’s insurance group number
  • Your office’s address, email, phone number, and fax number (if you have one)
  • Name of the team member who handles insurance claims in your office

Always stay polite, and on your patient’s side. And always – always – use the word “estimate.”

Start Educating Patients Early in the Year — and Don’t Stop

Most insurances renew the first day of the calendar year. This means that patients should know early on how their insurance works to make the best use of their benefits.

The earlier in the year you begin educating patients about dental insurance, the better — for your patients’ health and for your office.

Consider running an email campaign (or two) early in the year to educate patients on a couple key points about dental insurance. You can even send tailored campaigns based on patients’ specific plans.

Then, as the year closes, remind patients to use their remaining insurance benefits before they run out of time.

In other words, as Ben Tuinei likes to say, patient education on dental insurance should be ongoing, and it should teach patients not to rely only on insurance for their clinical needs.

Insurance doesn’t have to be a scary topic.

The more your patients (and your team) understand insurance, the easier it will be for your office to accomplish its primary goal: keeping your patients’ dental health in tip-top shape!


Learn more about how RevenueWell improves case acceptance and creates more close-knit relationships between dentists and their patients.

By RevenueWell