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TWO SIDES OF THE MANAGEMENT COIN: DENTAL BENEFIT PLANS
STAFF’S VIEWPOINT: BY: Linda Miles, CMC
DOCTOR’S VIEPOINT: BY: Rhonda Savage, DDS

Dental insurance can be a frustrating topic for dentists and dental team members. In this article, we’ll review common concerns from both sides, then present an end-of-the-year insurance benefits template that you can use for your insurance patients.

Staff’s Viewpoint

“There are just too many insurance plans to keep track of. Why don’t the patients understand their dental benefits?”

“I get so weary trying to explain these benefits.”

“It is so time-consuming to do pre-authorizations, and 80% of the patients still say ‘no’ to treatment after we wait for weeks to get the responses back. What a waste of time!”

“Doctor wants to become a provider of a few PPOs. We have always been fee for service. Why the change now?”

“We (the team members) will never get a raise if the practice writes off so much of our regular fees.”

Doctor’s Viewpoint

“The hardest part of practicing dentistry is the constant change in the patients’ benefit plans. How can one local business/company have so many different plans? No wonder the patients are confused. We need to hire a full-time dental benefits expert to keep our heads above water and our patients informed.”

“Why is it that so many patients must have in writing just exactly what their plan will cover? Most of their treatment plans exceed their annual maximum benefit. And it seems that the pre-determination is nothing but a delay tactic dreamed up by the insurance company knowing that 75% or more of the patients say no to their treatment plan by waiting to hear back in a few weeks.”

“In the past 20 years, I have remained fee for service, but it has become increasingly difficult to attract and keep patients in the slower economy as patients feel their ONLY OPTION is to go to a dentist on their plan. With so many dentists around me accepting XYZ plan, and as low as my new patient number is per month, I have two choices: either spend $6,000 per month on an expensive marketing plan to attract FFS patients or go on a plan or two to compete. I will have a busier schedule and write off about $4000 per month. At this point, I must reevaluate my pride, philosophy, and my marketing budget/versus write offs to measure the differences.”
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In this slower economy the past year, team members are spending an inordinate amount of time on insurance verifications, requested pre-authorizations, insurance follow up, billing and explanations of benefits. They are also handling more patient complaints regarding their dental benefit plans and out of pocket differences.

For the first time in 20 to 30 years, the die-hard, fee-for-service dentists are finding emptier chairs and less case acceptance than ever before. In order for practices to survive versus just get by month to month…right now is the time to send out the END OF THE YEAR INSURANCE LETTER to help patients maximize their benefits for the calendar year (if the benefit renews in January). Here is a sample that can help make October, November, December and January your four biggest months of all (December/January with split year cases to take advantage of benefits in both calendar years).

PATIENT LETTER OR CARD:

Just a friendly reminder….

Most insurance plans have a calendar year maximum and deductible period, and insurance maximums do not roll over from year to year. This means that if you have unused benefits at the end of the year, you lose them.

Each year, our schedule is very full in November and December as patients have dentistry completed to take advantage of their dental benefits. If you wish to have treatment completed before the end of the year, please call to schedule your appointment soon.

If you have questions about your benefits, or about recommended treatment, please don’t hesitate to call!
Remember, you earn your benefits, so make the most of them!